ABSTRACTBackground Hospital prealer

ABSTRACT
Background Hospital prealerting in acute stroke improves the timeliness of subsequent treatment, but little is known about the impact of prehospital assessments on in-hospital care. Objective Examine the association between prehospital assessments and notification by emergency medical service staff on the subsequent acute stroke care
pathway.

Methods This was a cohort study of linked patient medical records. Consenting patients with a diagnosis of stroke were recruited from two urban hospitals. Data from patient medical records were extracted and entered into a Cox regression analysis to investigate the association between time to CT request and recording of onset time, stroke recognition (using the Face Arm Speech Test (FAST)) and sending of a prealert message.

Results 151 patients (aged 71±15 years) travelled to hospital via ambulance and were eligible for this analysis. Time of symptom onset was recorded in 61 (40%) cases, the FAST test was positive in 114 (75%) and a prealert message was sent in 65 (44%). following adjustment for confounding, patients who had time of onset recorded (HR 0.73, 95% CI 0.52 to 1.03), were FAST-positive (HR 0.54, 95% CI 0.37 to 0.80) or were prealerted (HR 0.26, 95% CI 0.18 to 0.38), were more likely to receive a timely CT request in hospital.

Conclusions This study highlights the importance of hospital prealerting, accurate stroke recognition, and recording of onset time. Those not recognised with stroke in a prehospital setting appear to be excluded from the possibility of rapid treatment in hospital, even before they have been seen by a specialist.

Hasil (Bahasa Indonesia) 2:

ABSTRAK
Rumah Sakit Latar Belakang prealerting pada stroke akut meningkatkan ketepatan waktu pengobatan selanjutnya, tetapi sedikit yang diketahui tentang dampak penilaian pra-rumah sakit untuk perawatan di rumah sakit. Tujuan Periksa hubungan antara penilaian pra-rumah sakit dan pemberitahuan oleh staf pelayanan medis darurat pada perawatan stroke akut berikutnya
jalur. Metode Penelitian ini merupakan penelitian kohort terkait rekam medis pasien. Menyetujui pasien dengan diagnosis stroke direkrut dari dua rumah sakit perkotaan. Data dari catatan medis pasien diekstraksi dan dimasukkan ke dalam analisis regresi Cox untuk menyelidiki hubungan antara waktu permintaan CT dan pencatatan waktu onset, pengakuan stroke (menggunakan Wajah Arm Speech Test (CEPAT)) dan pengiriman pesan prealert. Hasil 151 pasien (usia 71 ± 15 tahun) pergi ke rumah sakit melalui ambulans dan memenuhi syarat untuk analisis ini. Waktu onset gejala tercatat di 61 (40%) kasus, tes cepat adalah positif di 114 (75%) dan pesan prealert dikirim dalam 65 (44%). Berikut penyesuaian untuk pembaur, pasien yang memiliki waktu onset tercatat (HR 0,73, 95% CI 0,52-1,03), yang cepat-positif (HR 0,54, 95% CI 0,37-0,80) atau yang prealerted (HR 0,26, 95% CI 0,18 0,38), lebih cenderung menerima permintaan CT tepat waktu di rumah sakit. Kesimpulan Studi ini menyoroti pentingnya prealerting rumah sakit, pengakuan stroke yang akurat, dan pencatatan waktu onset. Mereka tidak diakui stroke dalam pengaturan pra-rumah sakit tampaknya dikecualikan dari kemungkinan pengobatan yang cepat di rumah sakit, bahkan sebelum mereka telah dilihat oleh spesialis.